A brief history of pulmonary rehabilitation.

Pulmonary rehabilitation is widely accepted as effective therapy for patients with chronic obstructive pulmonary disease (COPD). This paper presents a brief (and somewhat subjective) history of pulmonary rehabilitation, and stresses the development of the exercise component. Until the middle of the 20th century, patients with COPD were advised to avoid the dyspnea that activity brings. Barach can be credited with positing that patients with COPD should strive to be more active. In the 1960s Petty created the multi-disciplinary team that was found to be effective in delivering pulmonary rehabilitation. In the 1980s doubts surfaced as to the ability of rehabilitative exercise to improve muscle function in COPD, but in the 1990s studies showed that well-designed exercise programs caused beneficial physiologic adaptations. The current decade has yielded studies that exploited those insights to design interventions that boost the effectiveness of rehabilitative exercise.